On the other hand, the addition of EX/RP to medication enhances the efficacy of the medication and OCD symptoms can be reduced further by adding EX/RP to medication treatment. Cognitive therapy OCD patients are distressed about their thoughts,
or obsessions, because they interpret them as warnings of events that are dangerous and likely to occur. Cognitive therapy (CT) is designed to help patients identify these automatic unrealistic thoughts and change their interpretations of the meaning of the thoughts, resulting in decreased anxiety and decreased compulsions. In the first stage of CT, patients are taught to develop an awareness of their worries as obsessions Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical and their rituals as compulsions. The patient keeps a daily diary of obsessions, called a thought record. In the thought record, patients write down their obsessions and the interpretations associated with the obsessions. Important details to record may include what the patient was doing when the obsession begin, the content of the obsession, the meaning attributed to the obsession, and what the patient did in response to the Inhibitors,research,lifescience,medical obsession (usually a compulsion). The therapist will review the thought record with the patient and how the obsession was interpreted. Using gentle
reasoning and Socratic questioning, the therapist will verbally challenge an unrealistic belief. This helps the patient to identify the cognitive distortion, typically a faulty assessment of danger, an exaggerated sense of responsibility, or fears that thinking something negative will make it come true (thought-action
fusion). Inhibitors,research,lifescience,medical Once patients are able to quickly identify their obsessions and Foretinib cell line compulsions as symptoms of OCD, the therapist will initiate a few behavioral experiments to disprove errors in thinking about cause and effect. For example, if a patient believes that smoking four cigarettes will prevent her family from being harmed in an auto Inhibitors,research,lifescience,medical accident, the therapist may ADAMTS5 instruct the patient to smoke only three cigarettes and then wait to see if family members are actually harmed that day in an auto accident. The therapist may then use the results of this experiment as material for discussion about other types of magical thinking. Over time, patients learn to identify and re-evaluate beliefs about the potential consequences of engaging in or refraining from compulsive behaviors and subsequently begin to eliminate compulsions (see ref 34). Cognitive therapy compared to in-vivo exposure with ritual prevention Van Oppen et al35 conducted a treatment study comparing CT with EX/RP. Seventy-one Dutch OCD patients were randomly assigned to either CT or in-vivo exposure. Sixteen 45-minute sessions were administered.